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1. Increased High-Density Lipoprotein Levels Associated with Age-Related Macular Degeneration

Author

Johanna M. Colijn, Anneke I. den Hollander, Ayse Demirkan, Audrey Cougnard-Grégoire, Timo Verzijden, Eveline Kersten, Magda A. Meester-Smoor, Benedicte M.J. Merle, Grigorios Papageorgiou, Shahzad Ahmad, Monique T. Mulder, Miguel Angelo Costa, Pascale Benlian, Geir Bertelsen, Alain M. Bron, Birte Claes, Catherine Creuzot-Garcher, Maja Gran Erke, Sascha Fauser, Paul J. Foster, Christopher J. Hammond, Hans-Werner Hense, Carel B. Hoyng, Anthony P. Khawaja, Jean-Francois Korobelnik, Stefano Piermarocchi, Tatiana Segato, Rufino Silva, Eric H. Souied, Katie M. Williams, Cornelia M. van Duijn, Cécile Delcourt, Caroline C.W. Klaver, Niyazi Acar, Lebriz Altay, Eleftherios Anastosopoulos, Augusto Azuara-Blanco, Tos Berendschot, Arthur Bergen, Christine Binquet, Alan Bird, Martin Bobak, Morten Bøgelund Larsen, Camiel Boon, Rupert Bourne, Lionel Brétillon, Rebecca Broe, Alain Bron, Gabrielle Buitendijk, Maria Luz Cachulo, Vittorio Capuano, Isabelle Carrière, Usha Chakravarthy, Michelle Chan, Petrus Chang, Johanna Colijn, Angela Cree, Phillippa Cumberland, José Cunha-Vaz, Vincent Daien, Eiko De Jong, Gabor Deak, Marie-Noëlle Delyfer, Anneke den Hollander, Martha Dietzel, Pedro Faria, Claudia Farinha, Robert Finger, Astrid Fletcher, Paul Foster, Panayiota Founti, Theo Gorgels, Jakob Grauslund, Franz Grus, Christopher Hammond, Thomas Heesterbeek, Manuel Hermann, René Hoehn, Ruth Hogg, Frank Holz, Carel Hoyng, Nomdo Jansonius, Sarah Janssen, Eiko de Jong, Anthony Khawaja, Caroline Klaver, Jean-François Korobelnik, Julia Lamparter, Mélanie Le Goff, Terho Lehtimäki, Irene Leung, Andrew Lotery, Matthias Mauschitz, Magda Meester, Bénédicte Merle, Verena Meyer zu Westrup, Edoardo Midena, Stefania Miotto, Alireza Mirshahi, Sadek Mohan-Saïd, Michael Mueller, Alyson Muldrew, Joaquim Murta, Stefan Nickels, Sandrina Nunes, Christopher Owen, Tunde Peto, Norbert Pfeiffer, Elena Prokofyeva, Jugnoo Rahi, Olli Raitakari, Franziska Rauscher, Luisa Ribeiro, Marie-Bénédicte Rougier, Alicja Rudnicka, José Sahel, Aggeliki Salonikiou, Clarisa Sanchez, Tina Schick, Steffen Schmitz-Valckenberg, Alexander Schuster, Cédric Schweitzer, Jasmin Shehata, Giuliana Silvestri, Christian Simader, Eric Souied, Martynas Speckauskas, Henriet Springelkamp, Robyn Tapp, Fotis Topouzis, Elisa van Leeuwen, Virginie Verhoeven, Hans Vingerling, Therese Von Hanno, Katie Williams, Christian Wolfram, Jennifer Yip, Jennyfer Zerbib, Soufiane Ajana, Blanca Arango-Gonzalez, Verena Arndt, Vaibhav Bhatia, Shomi S. Bhattacharya, Marc Biarnés, Anna Borrell, Sebastian Bühren, Sofia M. Calado, Sascha Dammeier, Eiko K. de Jong, Berta De la Cerda, Francisco J. Diaz-Corrales, Sigrid Diether, Eszter Emri, Tanja Endermann, Lucia L. Ferraro, Míriam Garcia, Thomas J. Heesterbeek, Sabina Honisch, Ellen Kilger, Hanno Langen, Imre Lengyel, Phil Luthert, Cyrille Maugeais, Magda Meester-Smoor, Bénédicte M.J. Merle Inserm, Jordi Monés, Everson Nogoceke, Frances M. Pool, Eduardo Rodríguez, Marius Ueffing, Karl U. Ulrich Bartz-Schmidt, Elisabeth M. van Leeuwen, and Markus Zumbansen

Subjects
genetic structures, Blood lipids, Physiology, Drusen, 03 medical and health sciences, Rotterdam Study, 0302 clinical medicine, Cholesterylester transfer protein, medicine, media_common.cataloged_instance, European union, 030304 developmental biology, media_common, 2. Zero hunger, 0303 health sciences, biology, business.industry, Lipid metabolism, Odds ratio, Macular degeneration, medicine.disease, eye diseases, 3. Good health, Ophthalmology, 030221 ophthalmology & optometry, biology.protein, lipids (amino acids, peptides, and proteins), sense organs, business
Abstract

PURPOSE: Genetic and epidemiologic studies have shown that lipid genes and High Density Lipoproteins (HDL) are implicated in age-related macular degeneration (AMD). We studied circulating lipid levels in relation to AMD in a large European dataset, and investigated whether this relationship is driven by certain sub fractions. DESIGN: (Pooled) analysis of cross-sectional data. PARTICIPANTS: 30,953 individuals aged 50+ participating in the E3 consortium; and 1530 individuals from the Rotterdam Study with lipid sub fraction data. METHODS: In E3, AMD features were graded per eye on fundus photographs using the Rotterdam Classification. Routine blood lipid measurements were available from each participant. Data on genetics, medication and confounders such as body mass index, were obtained from a common database. In a subgroup of the Rotterdam Study, lipid sub fractions were identified by the Nightingale biomarker platform. Random-intercepts mixed-effects models incorporating confounders and study site as a random-effect were used to estimate the associations. MAIN OUTCOME MEASURES: early, late or any AMD, phenotypic features of early AMD, lipid measurements. RESULTS: HDL was associated with an increased risk of AMD, corrected for potential confounders (Odds Ratio (OR) 1.21 per 1mmol/L increase (95% confidence interval[CI] 1.14-1.29); while triglycerides were associated with a decreased risk (OR 0.94 per 1mmol/L increase [95%CI 0.91-0.97]). Both were associated with drusen size, higher HDL raises the odds of larger drusen while higher triglycerides decreases the odds. LDL-cholesterol only reached statistical significance in the association with early AMD (p=0.045). Regarding lipid sub fractions: the concentration of extra-large HDL particles showed the most prominent association with AMD (OR 1.24 [95%CI 1.10-1.40]). The CETP risk variant (rs17231506) for AMD was in line with increased-HDL levels (p=7.7x10-7); but LIPC risk variants (rs2043085, rs2070895) were associated in an opposite way (p=1.0x10-6 and 1.6x10-4). CONCLUSIONS: Our study suggests that HDL-cholesterol is associated with increased risk of AMD and triglycerides negatively associated. Both show the strongest association with early AMD and drusen. Extra-large HDL sub fractions seem to be drivers in the relation with AMD, variants in lipid genes play a more ambiguous role in this association. Whether systemic lipids directly influence AMD or represent lipid metabolism in the retina remains a question to be answered.

Published
2019

2. Systemic and Ocular Determinants of Peripapillary Retinal Nerve Fiber Layer Thickness Measurements in the European Eye Epidemiology (E3) Population

Author

Matthias M. Mauschitz, Pieter W.M. Bonnemaijer, Kersten Diers, Franziska G. Rauscher, Tobias Elze, Christoph Engel, Markus Loeffler, Johanna Maria Colijn, M. Arfan Ikram, Johannes R. Vingerling, Katie M. Williams, Christopher J. Hammond, Catherine Creuzot-Garcher, Alain M. Bron, Rufino Silva, Sandrina Nunes, Cécile Delcourt, Audrey Cougnard-Grégoire, Frank G. Holz, Caroline C.W. Klaver, Monique M.B. Breteler, Robert P. Finger, Niyazi Acar, Eleftherios Anastosopoulos, Augusto Azuara-Blanco, Tos Berendschot, Arthur Bergen, Geir Bertelsen, Christine Binquet, Alan Bird, Martin Bobak, Morten Bøgelund Larsen, Camiel Boon, Rupert Bourne, Lionel Brétillon, Rebecca Broe, Alain Bron, Gabrielle Buitendijk, Maria Luz Cachulo, Vittorio Capuano, Isabelle Carrière, Usha Chakravarthy, Michelle Chan, Petrus Chang, Johanna Colijn, Angela Cree, Phillippa Cumberland, José Cunha-Vaz, Vincent Daien, Eiko De Jong, Gabor Deak, Marie-Noëlle Delyfer, Anneke den Hollander, Martha Dietzel, Maja Gran Erke, Pedro Faria, Claudia Farinha, Sascha Fauser, Robert Finger, Astrid Fletcher, Paul Foster, Panayiota Founti, Theo Gorgels, Jakob Grauslund, Franz Grus, Christopher Hammond, Hans-Werner Hense, Manuel Hermann, René Hoehn, Ruth Hogg, Frank Holz, Carel Hoyng, Nomdo Jansonius, Sarah Janssen, Eveline Kersten, Anthony Khawaja, Caroline Klaver, Jean-François Korobelnik, Julia Lamparter, Mélanie Le Goff, Yara Lechanteur, Terho Lehtimäki, Irene Leung, Andrew Lotery, Matthias Mauschitz, Magda Meester, Bénédicte Merle, Verena Meyer zu Westrup, Edoardo Midena, Stefania Miotto, Alireza Mirshahi, Sadek Mohan-Saïd, Michael Mueller, Alyson Muldrew, Joaquim Murta, Stefan Nickels, Christopher Owen, Tunde Peto, Norbert Pfeiffer, Stefano Piermarocchi, Elena Prokofyeva, Jugnoo Rahi, Olli Raitakari, Franziska Rauscher, Luisa Ribeiro, Marie-Bénédicte Rougier, Alicja Rudnicka, José Sahel, Aggeliki Salonikiou, Clarisa Sanchez, Steffen Schmitz-Valckenberg, Alexander Schuster, Cédric Schweitzer, Tatiana Segato, Jasmin Shehata, Giuliana Silvestri, Christian Simader, Eric Souied, Martynas Speckauskas, Henriet Springelkamp, Robyn Tapp, Fotis Topouzis, Elisa van Leeuwen, Virginie Verhoeven, Timo Verzijden, Therese Von Hanno, Peter Wiedemann, Katie Williams, Christian Wolfram, Jennifer Yip, Jennyfer Zerbib, OEil, nutrition et signalisation cellulaire [CSGA], Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Service d'Ophtalmologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Montrachet Study: Funding was provided by an Inter-regional grant (PHRC) and the Regional Council of Burgundy. Funded by INRA, CNRS, Université de Bourgogne, Regional Council of Burgundy France (PARI Agrale 1), FEDER (European Funding for Regional Economic Development), and French Government grant managed by the French National Research Agency (ANR) as part of the 'Investissements d’Avenir' program (reference ANR-11-LABX-0021-01-LipSTIC Labex)., Human Genetics, ANS - Cellular & Molecular Mechanisms, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, RS: MHeNs - R3 - Neuroscience, Oogheelkunde, MUMC+: MA UECM Oogartsen MUMC (9), Perceptual and Cognitive Neuroscience (PCN), Epidemiology, and Ophthalmology

Subjects
Retinal Ganglion Cells, Cross-Sectional Studies, Disease Progression, Europe, Glaucoma, Humans, Intraocular Pressure, Nerve Fibers, Optic Disk, Population Surveillance, Tomography, Optical Coherence, methods [Tomography, Optical Coherence], Intraocular pressure, OPTICAL COHERENCE TOMOGRAPHY, Cross-sectional study, Nerve Fibers/pathology, ANYANG CHILDHOOD EYE, AXIAL LENGTH, Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12], INTRAOCULAR-PRESSURE, Tomography, Optical Coherence/methods, Rotterdam Study, 0302 clinical medicine, physiopathology [Glaucoma], GLAUCOMA, epidemiology [Glaucoma], Tomography, education.field_of_study, GANGLION-CELL LAYER, epidemiology [Europe], pathology [Nerve Fibers], ASSOCIATION, 3. Good health, ALZHEIMERS-DISEASE, Population Surveillance/methods, pathology [Optic Disk], methods [Population Surveillance], Optic Disk/pathology, Cohort study, Glaucoma/diagnosis, medicine.medical_specialty, Population, physiology [Intraocular Pressure], Retinal Ganglion Cells/pathology, pathology [Retinal Ganglion Cells], Europe/epidemiology, 03 medical and health sciences, Ophthalmology, medicine, ddc:610, Intraocular Pressure/physiology, education, business.industry, diagnosis [Glaucoma], CONSORTIUM, medicine.disease, Confidence interval, ta3125, Optical Coherence, 030221 ophthalmology & optometry, DISC SIZE, business, Body mass index, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Purpose: To investigate systemic and ocular determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) in the European population.Design: Cross-sectional meta-analysis.Participants: A total of 16 084 European adults from 8 cohort studies (mean age range, 56.9 +/- 12.3-82.1 +/- 4.2 years) of the European Eye Epidemiology (E3) consortium.Methods: We examined associations with pRNFLT measured by spectral-domain OCT in each study using multivariable linear regression and pooled results using random effects meta-analysis.Main Outcome Measures: Determinants of pRNFLT.Results: Mean pRNFLT ranged from 86.8 +/- 21.4 mu m in the Rotterdam Study I to 104.7 +/- 12.5 mu m in the Rotterdam Study III. We found the following factors to be associated with reduced pRNFLT: Older age (beta = -0.38 mu m/year; 95% confidence interval [CI], -0.57 to -0.18), higher intraocular pressure (10P) (beta = -0.36 mu m/mmHg; 95% CI, -0.56 to -0.15), visual impairment (beta = -5.50 mu m; 95% CI, -9.37 to -1.64), and history of systemic hypertension (beta = -0.54 mu m; 95% CI, -1.01 to -0.07) and stroke (beta = -1.94 mu m; 95% CI, -3.17 to -0.72). A suggestive, albeit nonsignificant, association was observed for dementia (beta = -3.11 mu m; 95% CI, -6.22 to 0.01). Higher pRNFLT was associated with more hyperopic spherical equivalent (beta = 1.39 mu m/diopter; 95% CI, 1.19-1.59) and smoking (beta = 1.53 mu m; 95% CI, 1.00-2.06 for current smokers compared with never-smokers).Conclusions: In addition to previously described determinants such as age and refraction, we found that systemic vascular and neurovascular diseases were associated with reduced pRNFLT. These may be of clinical relevance, especially in glaucoma monitoring of patients with newly occurring vascular comorbidities. (C) 2018 by the American Academy of Ophthalmology

Published
2018

3. Prevalence of Age-Related Macular Degeneration in Europe

Author

Johanna M. Colijn, Gabriëlle H.S. Buitendijk, Elena Prokofyeva, Dalila Alves, Maria L. Cachulo, Anthony P. Khawaja, Audrey Cougnard-Gregoire, Bénédicte M.J. Merle, Christina Korb, Maja G. Erke, Alain Bron, Eleftherios Anastasopoulos, Magda A. Meester-Smoor, Tatiana Segato, Stefano Piermarocchi, Paulus T.V.M. de Jong, Johannes R. Vingerling, Fotis Topouzis, Catherine Creuzot-Garcher, Geir Bertelsen, Norbert Pfeiffer, Astrid E. Fletcher, Paul J. Foster, Rufino Silva, Jean-François Korobelnik, Cécile Delcourt, Caroline C.W. Klaver, Soufiane Ajana, Blanca Arango-Gonzalez, Verena Arndt, Vaibhav Bhatia, Shomi S. Bhattacharya, Marc Biarnés, Anna Borrell, Sebastian Bühren, Sofia M. Calado, Audrey Cougnard-Grégoire, Sascha Dammeier, Eiko K. de Jong, Berta De la Cerda, Anneke I. den Hollander, Francisco J. Diaz-Corrales, Sigrid Diether, Eszter Emri, Tanja Endermann, Lucia L. Ferraro, Míriam Garcia, Thomas J. Heesterbeek, Sabina Honisch, Carel B. Hoyng, Eveline Kersten, Ellen Kilger, Hanno Langen, Imre Lengyel, Phil Luthert, Cyrille Maugeais, Magda Meester-Smoor, Jordi Monés, Everson Nogoceke, Tunde Peto, Frances M. Pool, Eduardo Rodríguez, Marius Ueffing, Karl U. Ulrich Bartz-Schmidt, Elisabeth M. van Leeuwen, Timo Verzijden, Markus Zumbansen, Niyazi Acar, Eleftherios Anastosopoulos, Augusto Azuara-Blanco, Arthur Bergen, Christine Binquet, Alan Bird, Lionel Brétillon, Gabrielle Buitendijk, Maria Luz Cachulo, Usha Chakravarthy, Michelle Chan, Petrus Chang, Johanna Colijn, Philippa Cumberland, José Cunha-Vaz, Vincent Daien, Gabor Deak, Marie-Noëlle Delyfer, Anneke den Hollander, Martha Dietzel, Maja Gran Erke, Sascha Fauser, Robert Finger, Astrid Fletcher, Paul Foster, Panayiota Founti, Arno Göbel, Theo Gorgels, Jakob Grauslund, Franz Grus, Christopher Hammond, Catherine Helmer, Hans-Werner Hense, Manuel Hermann, René Hoehn, Ruth Hogg, Frank Holz, Carel Hoyng, Nomdo Jansonius, Sarah Janssen, Anthony Khawaja, Caroline Klaver, Julia Lamparter, Mélanie Le Goff, Sergio Leal, Yara Lechanteur, Terho Lehtimäki, Andrew Lotery, Irene Leung, Matthias Mauschitz, Bénédicte Merle, Verena Meyer zu Westrup, Edoardo Midena, Stefania Miotto, Alireza Mirshahi, Sadek Mohan-Saïd, Michael Mueller, Alyson Muldrew, Sandrina Nunes, Konrad Oexle, Jugnoo Rahi, Olli Raitakari, Luisa Ribeiro, Marie-Bénédicte Rougier, José Sahel, Aggeliki Salonikiou, Clarisa Sanchez, Steffen Schmitz-Valckenberg, Cédric Schweitzer, Jasmin Shehata, Giuliana Silvestri, Christian Simader, Eric Souied, Henriet Springelkamp, Robyn Tapp, Virginie Verhoeven, Therese Von Hanno, Stela Vujosevic, Katie Williams, Christian Wolfram, Jennifer Yip, Jennyfer Zerbib, Isabella Zwiener, Erasmus University Rotterdam, Scientific Institute for Public Health, Federal Agency for Medicines and Health Products, Partenaires INRAE, Association for Innovation and Biomedical Research on Light and Image (AIBILI), Universidade de Coimbra, Coimbra University Hospital (CHUC), University of Cambridge [UK] (CAM), Moorfields Eye Hospital NHS Foundation Trust, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB), Mainz University Medical Center, Oslo University Hospital [Oslo], Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Department of Ophthalmology, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Aristotle University of Thessaloniki, Universitad de Padua, Univ Padua, Dept Ophthalmol, Padua, Italy, Royal Netherlands Academy of Arts and Sciences (KNAW), University Hospital of North Norway [Tromsø] (UNN), London School of Hygiene and Tropical Medicine (LSHTM), Institute of Ophthalmology, University of Messina, CHU Bordeaux [Bordeaux], Radboud University Medical Center [Nijmegen], The European Eye Epidemiology (E3) Consortium, Epidemiology, Ophthalmology, Erasmus MC other, Other departments, ANS - Complex Trait Genetics, Human Genetics, and Genome Analysis

Subjects
0301 basic medicine, medicine.medical_specialty, Visual acuity, OPTICAL COHERENCE TOMOGRAPHY, MACULOPATHY, genetic structures, Population, Prevalence, HEART-DISEASE, choroidal neovascularization, Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12], 03 medical and health sciences, Rotterdam Study, 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, BEAVER DAM EYE, Epidemiology, geographic atrophy, medicine, VISUAL IMPAIRMENT, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, education, POPULATION, education.field_of_study, BIRTH COHORT, business.industry, Macular degeneration, medicine.disease, TRENDS, Confidence interval, eye diseases, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Ophthalmology, 030104 developmental biology, Age-related Macular Degeneration, ENDOTHELIAL GROWTH-FACTOR, BLINDNESS, 030221 ophthalmology & optometry, Optometry, Age-related Macular Degeneration, choroidal neovascularization, geographic atrophy, sense organs, medicine.symptom, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract

Manuscript no. 2016-1147 Supplemental material is available at www.aaojournal.org/; International audience; [u]Purpose:[/u] Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. [u]Design:[/u] Meta-analysis of prevalence data. [u]Participants:[/u] A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. [u]Methods:[/u] AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). [u]Main Outcome Measures:[/u] Prevalence of early and late AMD, BCVA, and number of AMD cases. [u]Results:[/u] Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1% -5.0%) in those aged 55-59 years to 17.6% (95% CI 13.6%-21.5%) in those aged >= 85 years; for late AMD these figures were 0.1% (95% CI 0.04%-0.3%) and 9.8% (95% CI 6.3%-13.3%), respectively. We observed a decreasing prevalence of late AMD after 2006, which became most prominent after age 70. Prevalences were similar for gender across all age groups except for late AMD in the oldest age category, and a trend was found showing a higher prevalence of CNV in Northern Europe. After 2006, fewer eyes and fewer >= 80-year-old subjects with CNV were visually impaired (P = 0.016). Projections of AMD showed an almost doubling of affected persons despite a decreasing prevalence. By 2040, the number of individuals in Europe with early AMD will range between 14.9 and 21.5 million, and for late AMD between 3.9 and 4.8 million. [u]Conclusion:[/u] We observed a decreasing prevalence of AMD and an improvement in visual acuity in CNV occuring over the past 2 decades in Europe. Healthier lifestyles and implementation of anti-vascular endothelial growth factor treatment are the most likely explanations. Nevertheless, the numbers of affected subjects will increase considerably in the next 2 decades. AMD continues to remain a significant public health problem among Europeans.

Published
2017

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